European Child & Adolescent Psychiatry最新文献

Suicide and self-harm are a leading cause of death globally, with females aged 15-24 years being a high-risk group requiring urgent intervention. Promoting mental health literacy is a well-established strategy for early intervention. No review has explored the available interventions promoting mental health literacy for female adolescents and their reach, effectiveness, adoption, implementation, and maintenance as a whole remains unknown. This study reviews existing interventions promoting mental health literacy in female adolescents. Searches included original peer-reviewed articles from inception to May 2024 across six databases, identifying twelve studies for review. Five independent meta-analyses were conducted, showing no significant effects immediately post-intervention for mental health literacy, knowledge, stigmatising attitudes, and help-provision. A significant reduction in stigmatising attitudes was found > 6 months post-intervention. Moderation analyses could not be performed due to insufficient data. None of the included studies reported on interventions specifically for female adolescents. This review also evaluated reporting of RE-AIM components, finding limited reporting on reach, adoption, and maintenance. These findings highlight a substantial gap in high-impact and tailored mental health prevention and promotion interventions for female adolescents. Therefore, there is a clear need to understand and target female adolescents' mental health literacy needs to develop and implement more effective interventions.

This study aims to explore the long-term physical, neurological, social and emotional development outcomes of the offspring born to patients with systemic lupus erythematosus (SLE), and to provide insights that can assist pediatricians in enhancing the long-term prognosis of these children. We conducted a cross-sectional study on the offspring of SLE patients who had undergone pregnancy and were admitted to our obstetrics department between January 1, 2016 and September 30, 2021. The control group consisted of offspring born to mothers without connective tissue disease, and was matched 1:1 based on age (birth date ± 1 month) with the offspring of SLE patients. Physical development, including measurements of weight and height (length), was assessed. The Ages and Stages Questionnaires, Third Edition (ASQ-3) was utilized to evaluate development in five domains: communication, gross motor, fine motor, problem solving, and personal-social. The Ages and Stages Questionnaires: Social-Emotional (ASQ: SE) was used to assess social-emotional development. Weight, height (length), BMI (body mass index), and ASQ-3 domain scores at different ages and for both genders were standardized into Z-scores for comparison. In the SLE group, the offspring demonstrated higher BMI Z-scores, higher rates of obesity, and increased probabilities of abnormal social-emotional development screening. In addition, their problem solving domain Z-scores were lower as compared to the control group. All of these differences were statistically significant. It is recommended that SLE patients should pay close attention to sensible feeding practices after the birth of their offspring to prevent the occurrence of obesity. Furthermore, there should be an emphasis on strengthening monitoring and intervention efforts to enhance the problem solving abilities and social-emotional development of the offspring. By implementing these measures, the overall long-term developmental outcomes of children born to SLE patients can be improved.

The directionality of the relationship between adolescent alcohol consumption and mental health difficulties remains poorly understood. This study investigates the longitudinal relationship between alcohol use frequency, internalizing and externalizing symptoms from the ages of 11 to 17. We conducted a random-intercept cross-lagged panel model across three timepoints (ages: 11yrs, 14yrs, 17yrs; 50.4% female) in the Millennium Cohort Study (N = 10,647). Survey weights were used to account for attrition. At each timepoint, past month alcohol use frequency was self-reported, parents and cohort members reported internalizing/externalizing symptoms using the Strengths and Difficulties Questionnaire. We controlled for alcohol expectancies, sex, and four cumulative risk indices (perinatal risk, early childhood adverse parenting, longitudinal parent-level risk occurrence, and persistent household socioeconomic deprivation). More frequent past month alcohol use at age 11 predicted increased internalizing symptoms at age 14 (β = 0.06; p =.01). More frequent past month alcohol use at age 14 predicted increased externalizing symptoms at age 17 (β = 0.11; p <.001). Increased internalizing symptoms consistently predicted reduced alcohol use at the next timepoint throughout the study period (11 years: β= -0.04; p =.03; 14 years: β= -0.09; p <.001). Increased externalizing symptoms at age 11 predicted increased alcohol consumption at age 14 (β = 0.06; p =.004). Frequent adolescent alcohol consumption represents a significant risk for subsequent mental health difficulties. Externalizing symptoms and alcohol use frequency appear to exacerbate one another. Internalizing symptoms may reduce the risk of frequent alcohol consumption. Incorporating routine alcohol screening into adolescent mental health treatment settings could reduce the risk of comorbid externalizing and alcohol use disorders.

While impaired response inhibition has been reported in attention-deficit/hyperactivity disorder (ADHD), findings in disruptive behavior disorders (DBDs) have been inconsistent, probably due to unaccounted effects of co-occurring ADHD in DBD. This study investigated the associations of behavioral and neural correlates of response inhibition with DBD and ADHD symptom severity, covarying for each other in a dimensional approach. Functional magnetic resonance imaging data were available for 35 children and adolescents with DBDs (8-18 years old, 19 males), and 31 age-matched unaffected controls (18 males) while performing a performance-adjusted stop-signal task. No significant association was found between behavioral performance and symptom severities. However, contrasting successful inhibition with failed inhibition revealed that DBD and ADHD symptom severity was associated with greater activation in the right inferior frontal regions and reduced activation in the bilateral striatal regions, respectively. During successful inhibition versus go-trials, ADHD symptom severity was associated with the left lateral occipital cortex activation. The contrast of failed inhibition versus go-trials revealed reduced activation in the right frontal and left parietal regions associated with DBD symptom severity while ADHD symptom severity was associated with bilateral precunei, dorsolateral prefrontal and left posterior parietal regions. Except for the right inferior frontal regions during successful versus failed inhibition, all clusters were also found to be inversely associated with the other dimension of interest (i.e., DBD or ADHD symptoms). Opposite direction of the associations between DBD and ADHD symptom severity, and fronto-parietal and fronto-striatal activation suggest unique contributions of DBD and ADHD to the neural correlates of response inhibition.

Important associations between emotional dysregulation (ED) and ADHD have been identified in adults, with a key manifestation of this being differential use of emotion regulation strategies: reduced use of cognitive reappraisal (CR), but elevated expressive suppression (ES). These associations have been observed at both behavioral and neuroimaging levels. The present study aims to explore the use of CR and ES in children with ADHD, and their relationship to ED. 148 children with ADHD and 265 healthy controls (age 9-16 years) were recruited and evaluated and correlated their ED, CR, and ES. Resting-state fMRI functional connectivity, with 6 amygdala subregions as regions-of-interest, were analyzed in a subsample to identify potential neural correlates. Children with ADHD showed significant higher ED, and lower use of both CR and ES. A significant negative correlation was found between CR and ED. Mediation analysis indicated that CR has an indirect influence on the relationship between ADHD diagnosis and ED. In the neuroimaging analyses, the functional connectivity between the right superficial amygdala and left middle occipital gyrus showed a significant group-by-ES interaction, highlighting potential neural correlates for elevated ED in children with ADHD. Children with ADHD expressed elevated levels of ED, and used less CR and ES compared to healthy controls. The lower use of ES may relate to abnormal amygdala connectivity in children with ADHD. This finding suggested that brain immaturity in children may preclude effective deployment of ES in emotion regulation processes.

Online therapies have the potential to improve access to psychological services for individuals in need while alleviating the burden on healthcare systems. However, child and adolescent psychiatrists and psychotherapists (CAPPs) rarely integrate these services into their daily practice. This exploratory study investigates CAPPs' acceptance of online therapy, with a focus on treating children and adolescents with digital media use disorders (DMUD). The study aimed to examine attitudes toward online therapy for DMUD treatment and to identify barriers and facilitating factors to its implementation. A cross-sectional online survey (5-10 min) was distributed to 1000 members of a German practitioner network, with 142 respondents completing it in full. Attitudes toward online therapy were assessed using adapted versions of the Attitude towards Telemedicine in Psychiatry and Psychotherapy (ATiPP) questionnaire. Barriers and facilitating factors were explored using open-ended questions. Descriptive statistics, correlations, and regressions were used to analyze the closed-ended questions, while responses to open-ended questions were categorized. CAPPs reported considerable experience with DMUD, but less experience with online therapy. Attitudes towards online therapy were generally neutral, with less favorable views on its use for DMUD treatment. Key barriers to implementation in outpatient care included technical challenges, lack of personal contact or control, and concerns about data security. Facilitators included access to adequate technical resources, user-friendly and evidence-based programs, interactive tools, and opportunities for regular face-to-face interactions. The results highlight the need to develop online therapy solutions that align practitioners' needs and acceptance. However, further qualitative and quantitative research with more representative samples is essential for a more comprehensive understanding of this topic.

Transcranial direct current stimulation (tDCS) remains experimental for many psychiatric disorders in adults. Particularly in childhood, there is limited research on the evidence for the efficacy and mechanisms of action of tDCS on the developing brain. The objective of this review is to identify published experimental studies to examine the efficacy and mechanisms of tDCS in children with psychiatric or developmental disorders in early (prepubertal) childhood (aged under 10 years). Included Studies should meet the following criteria: (1) experimental studies (no reviews, no case reports), (2) studies published in international peer-reviewed journals, (3) written in English, (4) conducted on children under 10 under years of age, (5) at enrolment with a psychiatric or developmental disorder.Eight studies were identified that fulfilled the specified criteria. All studies investigated effect on children with autism-spectrum-disorder (ASD). Anodal tDCS, mainly targeting the left dorsolateral prefrontal cortex (dlPFC), showed positive effects on the reduction of ASD symptoms. There has also been evidence that these stimulations are feasible, have good tolerability and are safe. tDCS was found to be safe and partially effective, but a long-term effect of tDCS and changes in connectivity during tDCS in autism has not been proven. Other developmental or psychiatric diseases were not investigated. This results in a lack of knowledge regarding the reactivity of the brain during the prepubertal period, which is a critical phase in the pathogenesis of neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD), ASD, Tourette's syndrome or dyslexia.

This protocol invites researchers and practitioners across Europe to establish a research network and disseminate role-playing interventions for suicidality prevention among adolescents. By understanding and targeting specific adolescent profiles, the aim is to improve preventive strategies that are evidence-based and cost-effective, incorporating methodologies similar to the Youth Aware of Mental Health (YAM) program while considering current restrictions due to ownership and copyright. This initiative seeks to facilitate better developmental trajectories for young people by fostering mental health and reducing suicide rates through collaborative efforts with public services, schools, and policymakers.

We investigated gene-environment interaction in ADHD traits, focusing on environmental variables related to personality traits, school environment, satisfaction with life, and callousness. Using data from 2170 16-year-old twins and state-of-the-art methodology to prevent spurious findings due to measurement scale artifacts, gene-environment interaction models were estimated separately for the two core ADHD dimensions, hyperactivity-impulsivity, and inattentiveness. Based on scores on the SWAN questionnaire, where high scores are reflective of low ADHD traits, results showed that additive genetic influences were more important in explaining individual differences in the degree of hyperactivity-impulsivity in twins with a high score on the trait conscientiousness than in twins with a moderate or low score (e.g., a positive gene-environment interaction). Similarly, additive genetic influences were relatively more important in explaining individual differences in the degree of inattentiveness in twins with a high score on conscientiousness or satisfaction with oneself. Lastly, a negative gene-environment interaction was found: For twins with a high score on the trait callousness, additive genetic influences were less important in explaining differences in the degree of inattentiveness than in twins with an average or low score on the trait. The finding of these specific gene-environment interactions is important for a deeper understanding of the etiology of ADHD traits and may assist in developing targeted interventions for genetically vulnerable individuals.